Over the last few months, I have had a truly surreal experience. It started when I noticed a two-page full color spread in TV Guide magazine advertising a product called Akavar 20/50. It contained the same claims that so many bogus weight loss products do: eat all you want and still lose weight. What attracted my interest was their highlighted statement: “We couldn’t say it in print if it wasn’t true!”
I laughed out loud. Anyone can say anything in print until they get caught. These diet ads all say things that aren’t true, and the FTC can’t begin to catch them all.
The ad describes research results they call “staggering.” They have scientific documentation that 23 out of 24 patients using Akavar’s active ingredient lost weight. They also described a controlled, randomized clinical trial of their actual product in which 23 out of 24 patients lost “a substantial amount of weight.” Two questions immediately came to mind: why were the numbers the same in both studies, and if a single active ingredient worked just as well, why was there any need to develop the Akavar formulation?
There was a toll-free number where I could call for further information. I called and asked for the citations of the two studies they referred to. The man who answered was flummoxed: “No one’s ever asked me that before.” He had to go for help. Finally he came up with the names of two journals and no further information.
I searched PubMed for anything in either of those journals that might even remotely be the studies they described, and I couldn’t find anything. I wrote the company’s customer service representative and asked for more information. And then the real fun began. Here are the actual e-mails for your delectation:
9/30 [Me] Your ad for Akavar describes a high rate of success in clinical studies. I’d like to read those studies for myself. I called your 800 number and the person who answered told me there were two studies published in the Journal of Human Nutrition and Dietetics and in the journal Medical Psychopharmacology. He was unable to give me the full citations, and I have searched PubMed and elsewhere and have been unable to locate the articles. Could you give me the exact citations (date, author, title of article, journal, volume and page number)? Or better yet, could you possibly send me electronic copies of the articles? I would really appreciate it.
10/9 [Akavar] Thank you for your interest in Akavar 20/50. I will be happy to submit a request to our Compliance dept and have these studies prepared for you to send via email or via mail. We request to know as to what use these will be used for and will require a phone # and address. As soon as I have this information I will submit the request and have these prepared for you to save any trouble of having to look these up yourself. Thanks so much.
10/9[Me] I would prefer you send them by e-mail. What they will be used for? To help me decide for myself whether there is adequate evidence to recommend Akavar 20/50 to patients.
10/10 [Akavar] Thank you so much for this.. I will forward this request to compliance and send via email when they have finished preparing the study
10/15 [Me] I’m still waiting. The delay is making me wonder… if you really have legitimate scientific studies to back up your claims, why are they not posted on your website or linked to the PubMed abstracts or at least listed in such a way that they can be located by interested physicians?
10/17 [Akavar] I apologize for the delay. I will follow up with our Compliance/Legal department to see if they have prepared these for you or not. I will let you know shortly.
10/30 [Me] It is now October 30, and I still have not received the studies. If they are not available in electronic format, all I really need is a proper citation: title of article, name of journal, names of authors, date, volume and page. If these studies really exist, and if they really support your product, your company certainly doesn’t seem very proud of them! If you cannot provide me with the citations, I will be forced to assume they do not exist and I will report your company for false advertising.
11/2 [Me] OK. Still no response. I will have to give you a deadline. If you have not sent me the citations by November 5, I will take it as an admission that you are crooks who tell deliberate lies in your advertising and I will report you to the FTC. I will remind you that ALL I’m asking is that you tell me where I can find the clinical studies you advertise as supporting your product.
11/2 [Akavar] I just spoke with our Legal department as I have been out of the office this week. They informed me that they are contacting you via mail as they are requesting more information from you. I can not handle this request other than our legal department. This was sent to the address you provided me below and should receive within normal postal delivery time. [I never received anything by mail.] I apologize sincerely for this delayed response. It should be taken care of now. Thank you,
11/2 [Me] How about you give me the e-mail address of the legal department so you don’t need to act as intermediary? There is no reason for them to request more information from me – that is ridiculous! And even if they are mailing me copies of the studies, there is no reason they can’t also immediately provide me with the citation information via e-mail. Reputable companies usually display that kind of information proudly on their websites, often with a link to the studies.
11/5 [Akavar] Our compliance/legal department has prepared the following for you and are sending via email at your request via the above attachments. Please respond accordingly.Thanks again for your patience. [Attachment] We have received your request to provide you with all studies relating to our Akavar 20/50 product. Due to the confidential nature of these studies, we cannot release these studies without a signed Non-Disclosure Agreement. Our standard Non- Disclosure Agreement is enclosed. Pleases review and sign the Agreement. Upon receipt of the signed Non-Disclosure Agreement, we will happily provide you the information you requested….. [This was accompanied by a complicated multi-page legal document.]
11/5 [Me] You have GOT to be kidding!! I did NOT ask for “all” studies relating to your product. I did NOT ask for any proprietary information. All I asked for was the correct citations for the two published studies referred to in your advertising. This is not anything that requires any signature or agreement. Published studies are in the public domain. This is becoming a surreal experience. Perhaps I’d better start all over again by copying my initial request: [My initial e-mail was copied here.] Let’s make this really simple: (1) Are there two published studies? (2) If so, please provide me with the information I will need to locate and read those studies: Name of author(s), title of article, name of journal, volume, page number and date of publication.
11/7 [Akavar] Any update from MKF?
11/7 [Me] No. Who or what is MKF?
11/13 [Akavar] We regret that you refused to sign the NDA, which would have allowed us to provide you the highly confidential, proprietary data related to Akavar. We are, however, enclosing the citations for the published articles relating to Akavar’s efficacy. [Lieberman, H.R., Tharion, W. J., Shukitt-Hale, B., Speckman, K.L., & Tulley, R. (2002). Psychopharmacology (Berl), 164(3), 250-261. Andersen, T. and J. Fogh (2001). J Hum Nutr Diet 14(3): 243-50.] Any representation on your part that the published studies comprise the full substantiation for Akavar 20/50 or that the substantiation is lacking in any way would be false and intentionally misleading on your part since your were not privy to the full documentation. again because of your refusal to sign a simple NDA. [This letter is signed by a paralegal.]
11/13 [Me] You did not provide the titles of the studies, but I easily found them. I can see why you didn’t provide the titles, and I can see why I didn’t find them when I looked before, because it is obvious that they were not studies of Akavar 20/50.The Lieberman study is titled “Effects of caffeine, sleep loss, and stress on cognitive performance and mood during U.S. Navy SEAL training. Sea-Air-Land.” The Andersen study is “Weight loss and delayed gastric emptying following a South American herbal preparation in overweight patients.” The herbal preparation was a mixture of yerba mate, guarana and damiana. The patients initially lost a few pounds, but those who took the active drug for 12 months “maintained” their weight during that period. The abstract of the study does not say that the study participants were instructed not to alter their eating habits. And the numbers of patients do not correspond to either of the studies described in your ads. Your ad says, “this is scientific fact, documented by published medical findings.” Are you now admitting that there are no published clinical studies of Akavar 20/50 and that the statements in your ads are false?
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I never heard back from them. This interchange only confirmed what I could tell just from reading the ad: they are using deceptive tactics to promote an untested product. They are only one of many. A recent JAMA article reviewed Internet advertising and found that more than half of the diet supplement ads they reviewed were not in compliance with the regulations of DSHEA (the Diet Supplement Health and Education Act of 1994).
I reported them to the FTC for false advertising. I was not the only one to complain. The National Advertising Review Council received an inquiry under the Electronic Retailing Self-Regulation Program (ERSP) and initiated “administrative closure” at the request of the company. There is also a website where lawyers are soliciting clients for a possible class action lawsuit against the company for its false and “shocking” claims.
Are you wondering what ingredients are in this miracle product? Among many other things, it does contain the three herbs that were used in the Andersen study they cited, but that study is a preliminary one, has not been confirmed elsewhere, and has too many flaws to take seriously. Any effect on weight loss is more likely due to the substantial amounts of caffeine and related xanthines it contains. Drinking lots of coffee is probably just as effective.
A recent issue of the Natural Medicines Comprehensive Database newsletter said: “Akavar 20/50 is a new supplement promoted for weight loss. It contains a long list of ingredients, including large amounts of caffeine from yerba mate, guarana, green tea, and kola nut extracts. It also contains damiana, ginger, schisandra, scutellaria, vitamin B6, magnesium, and other ingredients. Some research suggests that a few of these ingredients might help for weight loss, but this is preliminary. There is no proof that this specific combination of ingredients is effective. Product advertising says, ‘Eat all you want and still lose weight…’ Remind patients that if it sounds too good to be true, it probably is.”
This article was originally published in the Science-Based Medicine Blog and a slightly different version later appeared in Skeptical Inquirer.
